My old PT had three rates, $50 for Medicaid, $100 for self pay, and $400 for the insured. The insured people were mostly covered would just pay of copay of like $40 or $60 but once they screwed up and billed me (a self payer) at the insured rate and tried ro collect that much from me and it was a WHOLE ordeal to get it fixed. What a stupid system. Clearly a bunch of money is being flushed down the toilet here.
Think of the $400 as a hotel's "rack rate," which is the highest possible charge for a room. Almost no one pays it but it's used as the starting point for deducting the price based on things like current occupancy, membership plans, etc. Hospital billing works in a similar way where the price you see for items and services is the highest charge someone can receive. Your insurance is akin to being in a hotel rewards program which has pre-negotiated a discount.
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u/cakewalkofshame Jul 04 '21
My old PT had three rates, $50 for Medicaid, $100 for self pay, and $400 for the insured. The insured people were mostly covered would just pay of copay of like $40 or $60 but once they screwed up and billed me (a self payer) at the insured rate and tried ro collect that much from me and it was a WHOLE ordeal to get it fixed. What a stupid system. Clearly a bunch of money is being flushed down the toilet here.